Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/10756
Title: Outcomes following rheumatic mitral valve repair in children.
Authors: McGurty, Daniel
Remenyi, Boglarka
Cheung, Michael
Engelman, Daniel
Zannino, Diana
Milne, Catherine
Fittock, Marea
Steer, Andrew
Brizard, Christian
Affiliation: Cardiac surgery department, Royal Children's Hospital, Melbourne; Department of Paediatrics, The University of Melbourne, Melbourne. Electronic address: daniel.mcgurty@gmail.com..
Department of Paediatrics, The University of Melbourne, Melbourne; Paediatrics, Royal Darwin Hospital, Darwin; Menzies School of Health Research, Darwin..
Cardiology department, Royal Children's Hospital, Melbourne; Heart Research, Murdoch Children's Research Institute, Melbourne..
Centre for International Child Health, University of Melbourne, Melbourne..
Heart Research, Murdoch Children's Research Institute, Melbourne..
Northern Territory Rheumatic Heart Disease Control Program, NT Department of Health, Darwin..
Northern Territory Rheumatic Heart Disease Control Program, NT Department of Health, Darwin..
Centre for International Child Health, University of Melbourne, Melbourne..
Cardiac surgery department, Royal Children's Hospital, Melbourne; Department of Paediatrics, The University of Melbourne, Melbourne; Heart Research, Murdoch Children's Research Institute, Melbourne..
Issue Date: 2-May-2019
Citation: The Annals of thoracic surgery 2019-05-02
Abstract: It has been shown that mitral valve repair is superior to mechanical replacement in children with rheumatic heart disease, however there is limited data on the factors affecting the long-term durability of repaired mitral valves. We present here our experience following rheumatic mitral valve repair, adapting a risk score to clarify some novel predictors of repair instability. 79 children (median age 11.4 years) with rheumatic heart disease underwent their first mitral surgery between 1997 and 2015. Patients with concomitant aortic and tricuspid repair were included. Mean follow-up time was 7.72 years. Mitral deterioration (defined as cardiac death, reoperation or recurrent moderate to severe valvular disease) was used as a key endpoint. Preoperative echocardiographs were analysed and graded with respect to valvular mobility, subvalvular apparatus alteration and function. All patients had successful mitral valve repair. Seven patients died during follow-up. Kaplan-Meier analysis demonstrated survival at 15 years as 83%. 38 patients were deemed to have deterioration in mitral valve function, with freedom from deterioration at 15 years being 28%. Presence of an immobile anterior mitral leaflet preoperatively and the technique of posterior patch extension were shown to be significant determinants of mitral valve deterioration. The outcomes following mitral repair for rheumatic heart disease in the young are in keeping with previous studies. Whilst the survival is high, long-term valve stability was poor. Our findings suggest that the preoperative finding of a restricted anterior mitral leaflet is a negative predictor of repair durability.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/10756
DOI: 10.1016/j.athoracsur.2019.03.085
Type: Journal Article
Appears in Collections:NT Health digital library

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.